Full Length Research Paper
Abstract
Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli urinary tract infections represent a major global health problem, constituting a public health emergency with high patient morbidity and mortality. Temocillin serves as an alternative antibiotic for treating these infections and conserving carbapenems. A total of 209 isolates of uropathogenic Escherichia coli were collected in the Microbiology Laboratory of Niamey General Reference Hospital. The isolates underwent analysis using standard bacteriological methods. Identification and antibiotic susceptibility testing of Escherichia coli isolates were determined using the VITEK-2 system with the GN and AST-N372 cards. Of these isolates, 104 were subjected to ESBL testing. ESBL testing was performed with antibiotic discs of amoxicillin/clavulanic acid (20/10 µg), ceftazidime (30 µg), aztreonam (30 µg), and cefotaxime (30 µg) on Mueller Hinton agar, following the CA-SFM recommendations for 2019. Isolates that did not exhibit an ESBL phenotype were further tested on Mueller Hinton agar with cloxacillin for ESBL associated with AmpC cephalosporinase. Data were recorded and analyzed using EPI INFO software version 7.2.2.6. Microsoft Word and Excel software were utilized for word processing and figure creation. Out of the 209 Escherichia coli isolates, only 104 exhibited ESBL phenotypes, distributed as follows: 91/104 (43.54%) on Mueller Hinton agar and 13/104 (6.22%) on Mueller Hinton agar with cloxacillin, while the remaining 105 isolates did not produce ESBL (50.24%). The sensitivity of ESBL Escherichia coli isolates to temocillin was 62.5%. Temocillin demonstrated good activity against ESBL Escherichia coli isolates. However, it is recommended that empirical treatment with temocillin be included in the guidelines, making it an alternative antibiotic for conserving carbapenems in the treatment of urinary tract infections. Additionally, it can also be used against isolates producing AmpC enzymes.
Key words: Extended Spectrum Beta-lactam (ESBL), Escherichia coli, Temocillin, effectiveness, Niger.
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